BMC Infectious Diseases (May 2023)
Primary SARS-CoV-2 infection in patients with immune-mediated inflammatory diseases: long-term humoral immune responses and effects on disease activity
- Koos P. J. van Dam,
- Adriaan G. Volkers,
- Luuk Wieske,
- Eileen W. Stalman,
- Laura Y. L. Kummer,
- Zoé L. E. van Kempen,
- Joep Killestein,
- Sander W. Tas,
- Laura Boekel,
- Gerrit J. Wolbink,
- Anneke J. van der Kooi,
- Joost Raaphorst,
- R. Bart Takkenberg,
- Geert R. A. M. D’Haens,
- Phyllis I. Spuls,
- Marcel W. Bekkenk,
- Annelie H. Musters,
- Nicoline F. Post,
- Angela L. Bosma,
- Marc L. Hilhorst,
- Yosta Vegting,
- Frederike J. Bemelman,
- Alexandre E. Voskuyl,
- Bo Broens,
- Agner Parra Sanchez,
- Cécile A. C. M. van Els,
- Jelle de Wit,
- Abraham Rutgers,
- Karina de Leeuw,
- Barbara Horváth,
- Jan J. G. M. Verschuuren,
- Annabel M. Ruiter,
- Lotte van Ouwerkerk,
- Diane van der Woude,
- Renée C. F. Allaart,
- Y. K. Onno Teng,
- Pieter van Paassen,
- Matthias H. Busch,
- Papay B. P. Jallah,
- Esther Brusse,
- Pieter A. van Doorn,
- Adája E. Baars,
- Dirk Jan Hijnen,
- Corine R. G. Schreurs,
- W. Ludo van der Pol,
- H. Stephan Goedee,
- Maurice Steenhuis,
- Sofie Keijzer,
- Jim B. D. Keijser,
- Olvi Cristianawati,
- Anja ten Brinke,
- Niels J. M. Verstegen,
- S. Marieke van Ham,
- Theo Rispens,
- Taco W. Kuijpers,
- Mark Löwenberg,
- Filip Eftimov,
- on behalf of the T2B! Immunity against SARS-CoV-2 study group
Affiliations
- Koos P. J. van Dam
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location AMC, University of Amsterdam
- Adriaan G. Volkers
- Department of Gastroenterology and Hepatology, Location Academic Medical Center, Amsterdam UMC, University of Amsterdam
- Luuk Wieske
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location AMC, University of Amsterdam
- Eileen W. Stalman
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location AMC, University of Amsterdam
- Laura Y. L. Kummer
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location AMC, University of Amsterdam
- Zoé L. E. van Kempen
- Department of Neurology, Amsterdam UMC, VU University Medical Center
- Joep Killestein
- Department of Neurology, Amsterdam UMC, VU University Medical Center
- Sander W. Tas
- Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Department of Rheumatology and Clinical Immunology, University of Amsterdam
- Laura Boekel
- Amsterdam Rheumatology and Immunology Center, Location Reade, Department of Rheumatology
- Gerrit J. Wolbink
- Amsterdam Rheumatology and Immunology Center, Location Reade, Department of Rheumatology
- Anneke J. van der Kooi
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location AMC, University of Amsterdam
- Joost Raaphorst
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location AMC, University of Amsterdam
- R. Bart Takkenberg
- Department of Gastroenterology and Hepatology, Location Academic Medical Center, Amsterdam UMC, University of Amsterdam
- Geert R. A. M. D’Haens
- Department of Gastroenterology and Hepatology, Location Academic Medical Center, Amsterdam UMC, University of Amsterdam
- Phyllis I. Spuls
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam
- Marcel W. Bekkenk
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam
- Annelie H. Musters
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam
- Nicoline F. Post
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam
- Angela L. Bosma
- Department of Dermatology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam
- Marc L. Hilhorst
- Department of Internal Medicine, Section of Nephrology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam
- Yosta Vegting
- Department of Internal Medicine, Section of Nephrology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam
- Frederike J. Bemelman
- Department of Internal Medicine, Section of Nephrology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam
- Alexandre E. Voskuyl
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center
- Bo Broens
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center
- Agner Parra Sanchez
- Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Department of Rheumatology and Clinical Immunology, University of Amsterdam
- Cécile A. C. M. van Els
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM)
- Jelle de Wit
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM)
- Abraham Rutgers
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen
- Karina de Leeuw
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen
- Barbara Horváth
- Department of Dermatology, Center for Blistering Diseases, University Medical Center Groningen, University Groningen
- Jan J. G. M. Verschuuren
- Department of Neurology, Leiden University Medical Center
- Annabel M. Ruiter
- Department of Neurology, Leiden University Medical Center
- Lotte van Ouwerkerk
- Department of Rheumatology, Leiden University Medical Center
- Diane van der Woude
- Department of Rheumatology, Leiden University Medical Center
- Renée C. F. Allaart
- Department of Rheumatology, Leiden University Medical Center
- Y. K. Onno Teng
- Centre of Expertise for Lupus-, Vasculitis- and Complement-Mediated Systemic Diseases, Department of Internal Medicine – Nephrology section, Leiden University Medical Centre
- Pieter van Paassen
- Department of Nephrology and Clinical Immunology, Maastricht University Medical Center
- Matthias H. Busch
- Department of Nephrology and Clinical Immunology, Maastricht University Medical Center
- Papay B. P. Jallah
- Department of Nephrology and Clinical Immunology, Maastricht University Medical Center
- Esther Brusse
- Department of Neurology, Erasmus MC University Medical Center
- Pieter A. van Doorn
- Department of Neurology, Erasmus MC University Medical Center
- Adája E. Baars
- Department of Neurology, Erasmus MC University Medical Center
- Dirk Jan Hijnen
- Department of Dermatology, Erasmus MC University Medical Center
- Corine R. G. Schreurs
- Department of Dermatology, Erasmus MC University Medical Center
- W. Ludo van der Pol
- Department of Neurology and Neurosurgery, Brain Center UMC Utrecht
- H. Stephan Goedee
- Department of Neurology and Neurosurgery, Brain Center UMC Utrecht
- Maurice Steenhuis
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC
- Sofie Keijzer
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC
- Jim B. D. Keijser
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC
- Olvi Cristianawati
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC
- Anja ten Brinke
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC
- Niels J. M. Verstegen
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC
- S. Marieke van Ham
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC
- Theo Rispens
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Amsterdam UMC
- Taco W. Kuijpers
- Department of Pediatric Immunology, Rheumatology and Infectious Disease, Amsterdam UMC, Location AMC, University of Amsterdam
- Mark Löwenberg
- Department of Gastroenterology and Hepatology, Location Academic Medical Center, Amsterdam UMC, University of Amsterdam
- Filip Eftimov
- Department of Neurology and Neurophysiology, Amsterdam Neuroscience, Amsterdam UMC, Location AMC, University of Amsterdam
- on behalf of the T2B! Immunity against SARS-CoV-2 study group
- DOI
- https://doi.org/10.1186/s12879-023-08298-6
- Journal volume & issue
-
Vol. 23,
no. 1
pp. 1 – 11
Abstract
Abstract Background Patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressants (ISPs) may have impaired long-term humoral immune responses and increased disease activity after SARS-CoV-2 infection. We aimed to investigate long-term humoral immune responses against SARS-CoV-2 and increased disease activity after a primary SARS-CoV-2 infection in unvaccinated IMID patients on ISPs. Methods IMID patients on active treatment with ISPs and controls (i.e. IMID patients not on ISP and healthy controls) with a confirmed SARS-CoV-2 infection before first vaccination were included from an ongoing prospective cohort study (T2B! study). Clinical data on infections and increased disease activity were registered using electronic surveys and health records. A serum sample was collected before first vaccination to measure SARS-CoV-2 anti-receptor-binding domain (RBD) antibodies. Results In total, 193 IMID patients on ISP and 113 controls were included. Serum samples from 185 participants were available, with a median time of 173 days between infection and sample collection. The rate of seropositive IMID patients on ISPs was 78% compared to 100% in controls (p < 0.001). Seropositivity rates were lowest in patients on anti-CD20 (40.0%) and anti-tumor necrosis factor (TNF) agents (60.5%), as compared to other ISPs (p < 0.001 and p < 0.001, respectively). Increased disease activity after infection was reported by 68 of 260 patients (26.2%; 95% CI 21.2–31.8%), leading to ISP intensification in 6 out of these 68 patients (8.8%). Conclusion IMID patients using ISPs showed reduced long-term humoral immune responses after primary SARS-CoV-2 infection, which was mainly attributed to treatment with anti-CD20 and anti-TNF agents. Increased disease activity after SARS-CoV-2 infection was reported commonly, but was mostly mild. Trial registration NL74974.018.20, Trial ID: NL8900. Registered on 9 September 2020.
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